Cutting Edge Urology

T his PDF belongs to matthew.hooson@springer.co Indications for Baseline Biopsy PSA and/or rectal examination suspects remain the main indications for biopsy [1–4]. A prostate biopsy may be indicated for PSA values that exceed the thresholds of common use and almost always for values above 10 ng/ml; in this regard it is suggested to always repeat the PSA before making a decision. PSA level should be verified after a few weeks using the same assay under standardized conditions (i.e., no ejaculation, manipulations, urinary tract infections, prostate inflammation, and trauma) in the same laboratory [2, 3]. Empiric use of antibiotic in an asymp- tomatic patient in order to lower the PSA should not be undertaken [4]. Age, comorbidity of the patient, and therapeutic consequences are variables to consider when prescribing this procedure. Risk stratification is a potential tool for reducing unnecessary biopsies [1]. The transrectal ultrasound is considered the standard method to guide prostate biopsy and the removal of frustules done with transperineal or transrectal technique. In rare cases, such as rectal amputation, it may require a transperineal guide. It suggests a careful informed consent that explains to the patient the consequences of a pos- sible clinical diagnosis of cancer before the biopsy [5]. Preparation for Prostate Biopsy Sampling of the frustules of the prostate can result in bleeding inside the lodge and bladder. This occurrence is more frequent and severe in patients taking medications that interfere with clotting. For this reas on it is wise to suspen d, whenever possible, these drugs before the biopsy (aspirin, ticlopidine). In particular, the C oumadin and the Sintrom must be replaced by low molecular weight heparins [5]. Interventional Ultrasound: Transperineal and Transrectal Prostatic Biopsy Andrea Fandella, Pietro Pepe A. Fandella (  ) Unit of Urology, Casa di Cura Giovanni XXIII, Monastier di Treviso, TV, Italy e-mail: afandella@alice.it P. Pepe Unit of Urology,“Cannizzaro”Emergency Hospital, Catania, Italy Cutting EDGE_Urology(SUN)_final.indd 19 27-Mar-18 10:00:28 AM